Last update:


Arch Hellen Med, 30(4), July-August 2013, 467-472


Retained surgical items - A threat to perioperative safety in the 21st century?

A. Patelarou,1 M. Spanoudaki,1 A. Laliotis2
1Department of Anesthesiology, University Hospital of Heraklion, Heraklion, Crete,
2Department of Surgery, St Mark's Hospital, North West London Hospital NHS Trust, London, UK

The risk factors associated with retained surgical items, their effects on patient outcome and coping strategies and preventive measures have been extensively analyzed in the medical literature. Most of these unfortunate events have been documented in abdominal surgery, and of the retained items reported 68% were surgical gauze, 9% needles, 3% surgical equipment and 20% some other objects. Recent data indicate that the most significant risk factors are emergency procedures, increased body mass index (BMI) of the patient, unexpected findings during the operation, prolonged duration of surgery and extensive blood loss. The most common manifestations include pain, a palpable mass, fever and digestive tract symptoms, such as diarrhea, nausea or vomiting. In addition, sepsis is a common serious complication, which is often lethal. Increased awareness on the part of the health professionals and implementation of international guidelines in everyday practice are the key components of effective control of the problem. Modern technological innovations such as surgical gauze incorporating radiofrequency identification technology or data-matrix-coded sponge counting system encoding, help to improve and reduce the time of the gauze counting process and minimize the possibility of retention.

Key words: Retained surgical items, Safety, Surgery.

© Archives of Hellenic Medicine